Massage therapy · Kitchener–WaterlooChondral Defect

The knee joint is referred to as a synovial joint. This type of joint forms a connection between two bones that together make a moving joint. At the ends of the bones, the joint surface is lined with a smooth, low-friction material known as articular cartilage (American Academy of Orthopaedic Surgeons, n.d.a). The cartilage is lubricated by a film of fluid known as synovial fluid. This fluid is produced by an extremely thin lining known as the synovium. It is supported by a stronger fibrous structure surrounding the joint, known as the joint capsule.

Any portion of the joint is prone to injury. A common injury to the knee is a localised area of damaged or lost articular cartilage, referred to as a chondral defect. Sometimes the bone underneath the cartilage is injured as well. Cartilage can be damaged by an injury or by normal wear and tear (American Academy of Orthopaedic Surgeons, n.d.a).

Chondral Defect Anatomy

How to Treat a Chondral Defect

Treatments you may want to discuss with your family doctor or nurse practitioner

Tips

• Chondral defects are often caused by injury, for example in sports that put the knees through a lot of stress, or by wear and tear over time (American Academy of Orthopaedic Surgeons, n.d.a).
• People who injure other parts of the knee, such as the meniscus or ligaments, often have cartilage damage too (American Academy of Orthopaedic Surgeons, n.d.a).
• Occasionally a more significant accident can cause it, such as a car accident where the knee takes a heavy blow.
• Sports injuries can take an extended period of time to recover from.
• If you lift weights, make sure you perform the movements correctly to help prevent injuries to the knee.

Damaged knee cartilage has only a limited ability to heal, so the aim is to keep the knee strong and moving while managing the load it takes. Your doctor or surgeon decides whether you need surgery, and I work within their plan. After a cartilage operation, your surgeon sets the weight-bearing rules, brace use and timeline, and I need their okay before any hands-on treatment.

I start by assessing how your knee, hip and ankle move, the strength of your thigh and hip, and how you walk, squat and step.

Without Surgery

• Adjusting sport, lifting and daily activities to what your knee tolerates, rather than complete rest
• Hands-on work for the thigh, hamstrings, calf and hip, and gentle kneecap mobilisation
• Strength work from holds to sit-to-stands, step-ups and gym-based lifts at a load your knee accepts, with cycling or swimming for fitness

After Surgery

1. American Academy of Orthopaedic Surgeons (n.d.a) Articular cartilage restoration. OrthoInfo. Available at: https://orthoinfo.aaos.org/en/treatment/articular-cartilage-restoration/ (Accessed: 7 October 2026).
2. American Academy of Orthopaedic Surgeons (n.d.b) Common knee injuries. OrthoInfo. Available at: https://orthoinfo.aaos.org/en/diseases--conditions/common-knee-injuries/ (Accessed: 7 October 2026).
3. Kappe, T., Ludwig, M., Angenendt, M. et al. (2026) 'Treatment options for focal cartilage lesions of the knee', Deutsches Ärzteblatt International, 123(17), pp. 469–474. doi: 10.3238/arztebl.m2026.0073
4. Migliorini, F., Vaishya, R., Koettnitz, J. et al. (2025) 'Conservative management of focal chondral lesions of the knee and ankle: current concepts', Cells, 14(23), 1899. doi: 10.3390/cells14231899